"针刺临床试验干预措施报告标准"(Standards,for Reporting Interventions in Clinical Trials of Acupuncture,STRICTA)于2001年和2002年在5种期刊上发表。该指南以对照试验检查清单及解释的形式供作者和期刊编辑使用,旨在..."针刺临床试验干预措施报告标准"(Standards,for Reporting Interventions in Clinical Trials of Acupuncture,STRICTA)于2001年和2002年在5种期刊上发表。该指南以对照试验检查清单及解释的形式供作者和期刊编辑使用,旨在提高针刺临床试验报告的质量,尤其是对其中干预措施的报告,因而有助于对这些试验的解释和重复。随后对STRICTA的应用及影响的述评都强调了STRICTA的价值,也提出了改进和修订的建议。为使修订过程顺利进地,STRICTA工作组、CONSORT工作组和中国Cochrane中心于2008年开始合作,召集成立的包含47名成员的专家小组对清单的修改稿提出了电子版反馈意见。在后来于弗莱堡(Freiburg)召开的见面会上,由21名专家组成的工作组进一步修订了STRICTA对照检查清单,并计划如何对其进行发布。新的STRICTA对照检查清单作为CONSORT的正式扩展版,包含6项条目及17条二级条目。这些条目为报告针刺治疗的合理性、针刺的细节、治疗方案、其他干预措施、治疗师的背景以及对照或对照干预提供了指南。而且,作为修订工作的一部分,对每一条目作了详尽解释,并针对每一条目给出了良好报告的实例。此外,STRICTA中的"对照"(controlled)一词被替换成了"临床"(clinical),以示STRICTA适用于更广泛的各类临床评价设计,包括非对照结局研究和病例报道。修订的STRICTA对照检查清单有望与CONSORT声明及其非药物治疗扩展版一起共同提高针刺临床试验的报告质量。展开更多
当前农民过量和不平衡施用化肥现象严重,导致肥料利用率降低,影响到农田的可持续利用。因此,发展适合我国农业生产特点的养分管理和施肥方法尤为重要。本文介绍了基于作物产量反应和农学效率的推荐施肥新方法,该方法是以改进的SSNM(Site...当前农民过量和不平衡施用化肥现象严重,导致肥料利用率降低,影响到农田的可持续利用。因此,发展适合我国农业生产特点的养分管理和施肥方法尤为重要。本文介绍了基于作物产量反应和农学效率的推荐施肥新方法,该方法是以改进的SSNM(Site-specific Nutrient Management)和改进的QUEFTS(Quantitative Evaluation of the Fertility of Tropical Soils)模型参数为指导的养分管理和推荐施肥为原则,同时考虑大、中微量元素的全面平衡,并应用计算机软件技术把复杂和综合的养分管理原则智能化形成可为当地技术推广人员掌握的Nutrient Expert推荐施肥专家系统。Nutrient Expert推荐施肥专家系统在用户回答一些简单问题后就能给出基于作物栽培管理措施的推荐施肥套餐,包括作物种植密度、目标产量、推荐的养分用量及其可选用的物化的肥料用量,同时根据预知的作物生长季节推荐施肥的最佳时间和次数。通过跨区域田间多点验证试验证明,基于作物产量反应和农学效率的推荐施肥方法是一种简单的易于掌握的作物增产增收、提高肥料利用率和保护环境的新方法。展开更多
Dementia is one of the greatest global challenges for health and social care in the 21st century.Alzheimer’s disease(AD),the most common type of dementia,is by no means an inevitable consequence of growing old.Severa...Dementia is one of the greatest global challenges for health and social care in the 21st century.Alzheimer’s disease(AD),the most common type of dementia,is by no means an inevitable consequence of growing old.Several lifestyle factors may increase,or reduce,an individual’s risk of developing AD.Much has been written over the ages about the benefits of exercise and physical activity.Among the risk factors associated with AD is a low level of physical activity.The relationship between physical and mental health was established several years ago.In this review,we discuss the role of exercise(aerobic and resistance)training as a therapeutic strategy for the treatment and prevention of AD.Older adults who exercise are more likely to maintain cognition.We address the main protective mechanism on brain function modulated by physical exercise by examining both human and animal studies.We will pay especial attention to the potential role of exercise in the modulation of amyloid b turnover,inflammation,synthesis and release of neurotrophins,and improvements in cerebral blood flow.Promoting changes in lifestyle in presymptomatic and predementia disease stages may have the potential for delaying one-third of dementias worldwide.Multimodal interventions that include the adoption of an active lifestyle should be recommended for older populations.展开更多
"针刺临床试验干预措施报告标准"(STandards for Reporting Interventions in Clinical Trials of Acupuncture,STRICTA)于2001年和2002年在5种期刊上发表。该指南以对照检查清单及解释的形式供作者和期刊编辑使用,旨在提高..."针刺临床试验干预措施报告标准"(STandards for Reporting Interventions in Clinical Trials of Acupuncture,STRICTA)于2001年和2002年在5种期刊上发表。该指南以对照检查清单及解释的形式供作者和期刊编辑使用,旨在提高针刺临床试验报告的质量,尤其是对其中干预措施的报告,因而有助于对这些试验的解释和重复。随后对STRICTA的应用及影响的述评都强调了STRICTA的价值,也提出了改进和修订的建议。为使修订过程顺利进行,STRICTA工作组、CONSORT工作组和中国Cochrane中心于2008年开始合作。召集成立的有47名成员的专家组对清单的修改稿提出了电子版反馈意见。在后来于弗莱堡(Freiburg)召开的见面会上,由21名专家组成的工作组进一步修订了STRICTA对照检查清单,并计划如何对其进行发布。新的STRICTA对照检查清单作为CONSORT的正式扩展版,包含6项条目及17条二级条目。这些条目为报告针刺治疗的合理性、针刺的细节、治疗方案、其他干预措施、治疗师的背景以及对照或对照干预提供了指南。而且,作为修订工作的一部分,对每一条目作了详尽解释,并针对每一条目给出了报告良好的实例。此外,STRICTA中的"对照"(controlled)一词被替换成了"临床"(clinical),以示STRICTA适用于更广泛的各类临床评价设计,包括非对照结局研究和病例报道。修订的STRICTA对照检查清单有望与CONSORT声明及其非药物治疗扩展版一起共同提高针刺临床试验的报告质量。展开更多
In this review,we discussed the findings and concepts underlying the potential role of Helicobacter pylori(H.pylori) infections in the initiation,development or persistence of atherosclerosis and coronary heart diseas...In this review,we discussed the findings and concepts underlying the potential role of Helicobacter pylori(H.pylori) infections in the initiation,development or persistence of atherosclerosis and coronary heart disease(CHD).This Gram-negative bacterium was described by Marshall and Warren in 1984.The majority of infected subjects carries and transmits H.pylori with no symptoms; however,in some individuals these bacteria may cause peptic ulcers,and even gastric cancers.The widespread prevalence of H.pylori infections and the fact that frequently they remain asymptomatic may suggest that,similarly to intestinal microflora,H.pylori may deliver antigens that stimulate not only local,but also systemic inflammatory response.Recently,possible association between H.pylori infection and extragastric disorders has been suggested.Knowledge on the etiology of atherosclerosis together with current findings in the area of H.pylori infections constitute the background for the newly proposed hypothesis that those two processes may be related.Many research studies confirm the indirect association between the prevalence of H.pylori and the occurrence of CHD.According to majority of findings the involvement of H.pylori in this process is based on the chronic inflammation which might facilitate the CHDrelated pathologies.It needs to be elucidated,if the infection initiates or just accelerates the formation of atheromatous plaque.展开更多
Conventional ultrasound(US)is the recommended imaging method for lymph node(LN)diseases with the advantages of high resolution,real time evaluation and relative low costs.Current indications of transcutaneous ultrasou...Conventional ultrasound(US)is the recommended imaging method for lymph node(LN)diseases with the advantages of high resolution,real time evaluation and relative low costs.Current indications of transcutaneous ultrasound and endoscopic ultrasound include the detection and characterization of lymph nodes and the guidance for LN biopsy.Recent advances in US technology,such as contrast enhanced ultrasound(CEUS),contrast enhanced endoscopic ultrasound(CE-EUS),and real time elastography show potential to improve the accuracy of US for the differential diagnosis of benign and malignant lymph nodes.In addition,CEUS and CE-EUS have been also used for the guidance of fine needle aspiration and assessment of treatment response.Complementary to size criteria,CEUS could also be used to evaluate response of tumor angiogenesis to anti-angiogenic therapies.In this paper we review current literature regarding evaluation of lymphadenopathy by new and innovative US techniques.展开更多
Despite a decrease in gastric cancer incidence, the development of novel biologic agents and combined therapeutic strategies, the prognosis of gastric cancer remains poor. Recently, the introduction of modern immunoth...Despite a decrease in gastric cancer incidence, the development of novel biologic agents and combined therapeutic strategies, the prognosis of gastric cancer remains poor. Recently, the introduction of modern immunotherapy, especially using immune checkpoint inhibitors, led to an improved prognosis in many cancers. The use of immunotherapy was also associated with manageable adverse event profiles and promising results in the treatment of patients with gastric cancer, especially in heavily pretreated patients. These data have led to an accelerated approval of some checkpoint inhibitors in this setting. Understanding the complex relationship between the host immune microenvironment and tumor and the immune escape phenomenon leading to cancer occurrence and progression will subsequently lead to the identification of prognostic immune markers. Furthermore, this understanding will result in the discovery of both new mechanisms for blocking tumor immunosuppressive signals and pathways to stimulate the local immune response by targeting and modulating different subsets of immune cells. Due to the molecular heterogeneity of gastric cancers associated with differentclinico-biologic parameters, immune markers expression and prognosis, novel immunotherapy algorithms should be personalized and addressed to selected subsets of gastric tumors, which have been proven to elicit the best clinical responses. Future perspectives in the treatment of gastric cancer include tailored dual immunotherapies or a combination of immunotherapy with other targeted agents with synergistic antitumor effects.展开更多
AIM: To analyze contrast-enhanced ultrasound(CEUS) features of histologically proven hepatic epithelioid hemangioendothelioma(HEHE) in comparison to other multilocular benign focal liver lesions(FLL).METHODS: Twenty-f...AIM: To analyze contrast-enhanced ultrasound(CEUS) features of histologically proven hepatic epithelioid hemangioendothelioma(HEHE) in comparison to other multilocular benign focal liver lesions(FLL).METHODS: Twenty-five patients with histologically proven HEHE and 45 patients with histologically proven multilocular benign FLL were retrospectively reviewed. Four radiologists assessed the CEUS enhancement pattern in consensus.RESULTS: HEHE manifested as a single(n = 3) or multinodular(n = 22) FLL. On CEUS, HEHE showed rim-like(18/25, 72%) or heterogeneous hyperenhancement(7/25, 28%) in the arterial phase and hypoenhancement(25/25, 100%) in the portal venous and late phases(PVLP), a sign of malignancy. Eighteen patients showed central unenhanced areas(18/25, 72%); in seven patients(7/25, 28%), more lesions were detected in the PVLP. In contrast, all patients with hemangioma and focal nodular hyperplasia showed hyperenhancement as the most distinctive feature(P < 0.01).CONCLUSION: CEUS allows for characterization of unequivocal FLL. By analyzing the hypoenhancement in the PVLP, CEUS can determine the malignant nature of HEHE.展开更多
此麻醉安全国际标准由世界麻醉医师学会联盟(World Federation of Societies of Anaesthesiologists,WFSA)和世界卫生组织(World Health Organization,WHO)联合制订。WFSA是由150个国家的麻醉医师组成的非营利组织。本文所推荐的标准已...此麻醉安全国际标准由世界麻醉医师学会联盟(World Federation of Societies of Anaesthesiologists,WFSA)和世界卫生组织(World Health Organization,WHO)联合制订。WFSA是由150个国家的麻醉医师组成的非营利组织。本文所推荐的标准已获得WHO和WFSA成员支持,此标准适用于世界各地的麻醉工作者,旨在为麻醉工作者、专业组织、医院、机构管理者和政府提供指导和帮助,以维持和提高麻醉安全和质量。此标准涵盖专业内容、设施设备、用药及静脉输液、监测和麻醉实施等方面。高度推荐标准与强制标准作用等同,包括(但不仅限于):训练有素的、警惕的麻醉工作者持续在场,通过临床观察及脉搏血氧饱和度持续监测组织氧合及灌注;间断监测血压;通过听诊和二氧化碳检测确认气管内插管(如果有)的正确位置;应用WHO手术安全核查单;麻醉结束时完善交接系统。此国际标准仅为最低标准,而我们的目标是以所能达到的最高标准来实施麻醉,所以实际标准最好超过本文所介绍的标准。展开更多
Acute epididymitis represents a common medical condition in the urological outpatient clinic. Mostly, epididymitis is caused by bacterial ascent through the urogenital tract, with pathogens originating either from sex...Acute epididymitis represents a common medical condition in the urological outpatient clinic. Mostly, epididymitis is caused by bacterial ascent through the urogenital tract, with pathogens originating either from sexually transmitted diseases or urinary tract infections. Although conservative antimicrobial therapy is possible in the majority of patients and is usually sufficient to eradicate the pathogen, studies have shown persistent oligozoospermia and azoospermia in up to 40% of these patients. Animal models of epididymitis are created to delineate the underlying reasons for this observation and the additional impairment of sperm function that is often associated with the disease. Accumulated data provide evidence of a differential expression of immune cells, immunoregulatory genes and pathogen-sensing molecules along the length of the epididymal duct. The evidence suggests that a tolerogenic environment exists in the caput epididymidis, but that inflammatory responses are most intense toward the cauda epididymidis. This is consistent with the need to provide protection for the neo-antigens of spermatozoa emerging from the testis, without compromising the ability to respond to ascending infections. However, severe inflammatory responses, particularly in the cauda, may lead to collateral damage to the structure and function of the epididymis. Convergence of the clinical observations with appropriate animal studies should lead to better understanding of the immunological environment throughout the epididymis, the parameters underlying susceptibility to epididymitis, and to therapeutic approaches that can mitigate epididymal damage and subsequent fertility problems.展开更多
Ultrasound (US) is often the first imaging modality employed in patients with suspected focal liver lesions. The role of US in the characterisation of focal liver lesions has been transformed with the introduction of ...Ultrasound (US) is often the first imaging modality employed in patients with suspected focal liver lesions. The role of US in the characterisation of focal liver lesions has been transformed with the introduction of specific contrast media and the development of specialized imaging techniques. Ultrasound now can fully characterise the enhancement pattern of hepatic lesions, similar to that achieved with contrast enhanced multiphasic computed tomography (CT) and magnetic resonance imaging (MRI). US contrast agents are safe, well-tolerated and have very few contraindications. Furthermore, real-time evaluation of the vascularity of focal liver lesions has become possible with the use of the newer microbubble contrast agents. This article reviews the enhancement pattern of the most frequent liver lesions seen, using the second generation US contrast media. The common pitfalls for each type of lesion are discussed. The recent developments in US contrast media and specific imaging techniques have been a major advance and this technique, in view of the intrinsic advantages of US, will undoubtedly gain popularity in the years to come.展开更多
In this paper we present the enhanced X-ray Timing and Polarimetry mission—eXTP. eXTP is a space science mission designed to study fundamental physics under extreme conditions of density, gravity and magnetism. The m...In this paper we present the enhanced X-ray Timing and Polarimetry mission—eXTP. eXTP is a space science mission designed to study fundamental physics under extreme conditions of density, gravity and magnetism. The mission aims at determining the equation of state of matter at supra-nuclear density, measuring effects of QED, and understanding the dynamics of matter in strong-field gravity. In addition to investigating fundamental physics, eXTP will be a very powerful observatory for astrophysics that will provide observations of unprecedented quality on a variety of galactic and extragalactic objects. In particular, its wide field monitoring capabilities will be highly instrumental to detect the electro-magnetic counterparts of gravitational wave sources.The paper provides a detailed description of:(1) the technological and technical aspects, and the expected performance of the instruments of the scientific payload;(2) the elements and functions of the mission, from the spacecraft to the ground segment.展开更多
Gallstones represent the most frequent aetiology of acute pancreatitis in many statistics all over the world, estimated between 40%-60%. Accurate diagnosis of acute biliary pancreatitis(ABP) is of outmost importance b...Gallstones represent the most frequent aetiology of acute pancreatitis in many statistics all over the world, estimated between 40%-60%. Accurate diagnosis of acute biliary pancreatitis(ABP) is of outmost importance because clearance of lithiasis [gallbladder and common bile duct(CBD)] rules out recurrences. Confirmation of biliary lithiasis is done by imaging. The sensitivity of the ultrasonography(US) in the detection of gallstones is over 95% in uncomplicated cases, but in ABP, sensitivity for gallstone detection is lower, being less than 80% due to the ileus and bowel distension. Sensitivity of transabdominal ultrasonography(TUS) for choledocolithiasis varies between 50%-80%, but the specificity is high, reaching 95%. Diameter of the bile duct may be orientative for diagnosis. Endoscopic ultrasonography(EUS) seems to be a more effectivetool to diagnose ABP rather than endoscopic retrograde cholangiopancreatography(ERCP),which should be performed only for therapeutic purposes.As the sensitivity and specificity of computerized tomography are lower as compared to state-of-the-art magnetic resonance cholangiopancreatography(MRCP)or EUS,especially for small stones and small diameter of CBD,the later techniques are nowadays preferred for the evaluation of ABP patients.ERCP has the highest accuracy for the diagnosis of choledocholithiasis and is used as a reference standard in many studies,especially after sphincterotomy and balloon extraction of CBD stones.Laparoscopic ultrasonography is a useful tool for the intraoperative diagnosis of choledocholithiasis.Routine exploration of the CBD in cases of patients scheduled for cholecystectomy after an attack of ABP was not proven useful.A significant rate of the so-called idiopathic pancreatitis is actually caused by microlithiasis and/or biliary sludge.In conclusion,the general algorithm for CBD stone detection starts with anamnesis,serum biochemistry and then TUS,followed by EUS or MRCP.In the end,bile duct microscopic analysis may be performed by bile harvested during展开更多
文摘"针刺临床试验干预措施报告标准"(Standards,for Reporting Interventions in Clinical Trials of Acupuncture,STRICTA)于2001年和2002年在5种期刊上发表。该指南以对照试验检查清单及解释的形式供作者和期刊编辑使用,旨在提高针刺临床试验报告的质量,尤其是对其中干预措施的报告,因而有助于对这些试验的解释和重复。随后对STRICTA的应用及影响的述评都强调了STRICTA的价值,也提出了改进和修订的建议。为使修订过程顺利进地,STRICTA工作组、CONSORT工作组和中国Cochrane中心于2008年开始合作,召集成立的包含47名成员的专家小组对清单的修改稿提出了电子版反馈意见。在后来于弗莱堡(Freiburg)召开的见面会上,由21名专家组成的工作组进一步修订了STRICTA对照检查清单,并计划如何对其进行发布。新的STRICTA对照检查清单作为CONSORT的正式扩展版,包含6项条目及17条二级条目。这些条目为报告针刺治疗的合理性、针刺的细节、治疗方案、其他干预措施、治疗师的背景以及对照或对照干预提供了指南。而且,作为修订工作的一部分,对每一条目作了详尽解释,并针对每一条目给出了良好报告的实例。此外,STRICTA中的"对照"(controlled)一词被替换成了"临床"(clinical),以示STRICTA适用于更广泛的各类临床评价设计,包括非对照结局研究和病例报道。修订的STRICTA对照检查清单有望与CONSORT声明及其非药物治疗扩展版一起共同提高针刺临床试验的报告质量。
文摘当前农民过量和不平衡施用化肥现象严重,导致肥料利用率降低,影响到农田的可持续利用。因此,发展适合我国农业生产特点的养分管理和施肥方法尤为重要。本文介绍了基于作物产量反应和农学效率的推荐施肥新方法,该方法是以改进的SSNM(Site-specific Nutrient Management)和改进的QUEFTS(Quantitative Evaluation of the Fertility of Tropical Soils)模型参数为指导的养分管理和推荐施肥为原则,同时考虑大、中微量元素的全面平衡,并应用计算机软件技术把复杂和综合的养分管理原则智能化形成可为当地技术推广人员掌握的Nutrient Expert推荐施肥专家系统。Nutrient Expert推荐施肥专家系统在用户回答一些简单问题后就能给出基于作物栽培管理措施的推荐施肥套餐,包括作物种植密度、目标产量、推荐的养分用量及其可选用的物化的肥料用量,同时根据预知的作物生长季节推荐施肥的最佳时间和次数。通过跨区域田间多点验证试验证明,基于作物产量反应和农学效率的推荐施肥方法是一种简单的易于掌握的作物增产增收、提高肥料利用率和保护环境的新方法。
基金TagedPThis work was supported by the following grants:Instituto de Salud Carlos III and co-funded by FEDER(Grant number PIE15/00013)SAF2016-75508-R from the Spanish Ministry of Education and Science(MEC)+2 种基金CB16/10/00435(CIBERFES)PROMETEOII2014/056 from Conselleria,de Sanitat de la Generalitat Valenciana and EU Funded CM1001 and FRAILOMICHEALTH.2012.2.1.1-2ADVANTAGE-724099 Join Action(HP-JA)3rd EU Health Programme and DIALBFRAIL-LATAM(825546 H2020-SC1-BHC).
文摘Dementia is one of the greatest global challenges for health and social care in the 21st century.Alzheimer’s disease(AD),the most common type of dementia,is by no means an inevitable consequence of growing old.Several lifestyle factors may increase,or reduce,an individual’s risk of developing AD.Much has been written over the ages about the benefits of exercise and physical activity.Among the risk factors associated with AD is a low level of physical activity.The relationship between physical and mental health was established several years ago.In this review,we discuss the role of exercise(aerobic and resistance)training as a therapeutic strategy for the treatment and prevention of AD.Older adults who exercise are more likely to maintain cognition.We address the main protective mechanism on brain function modulated by physical exercise by examining both human and animal studies.We will pay especial attention to the potential role of exercise in the modulation of amyloid b turnover,inflammation,synthesis and release of neurotrophins,and improvements in cerebral blood flow.Promoting changes in lifestyle in presymptomatic and predementia disease stages may have the potential for delaying one-third of dementias worldwide.Multimodal interventions that include the adoption of an active lifestyle should be recommended for older populations.
基金White RoseHealth Innovation Partnership Enterprise and Innovation Office+7 种基金 Charles Thackrah Building 101 Clarendon RoadLeeds LS2 9LJLeeds UK提供资金支持UK National Institute for Health Research的一项Career Scientist Award资助Cancer Research UK资助University of Ottawa Research Chair资助
文摘"针刺临床试验干预措施报告标准"(STandards for Reporting Interventions in Clinical Trials of Acupuncture,STRICTA)于2001年和2002年在5种期刊上发表。该指南以对照检查清单及解释的形式供作者和期刊编辑使用,旨在提高针刺临床试验报告的质量,尤其是对其中干预措施的报告,因而有助于对这些试验的解释和重复。随后对STRICTA的应用及影响的述评都强调了STRICTA的价值,也提出了改进和修订的建议。为使修订过程顺利进行,STRICTA工作组、CONSORT工作组和中国Cochrane中心于2008年开始合作。召集成立的有47名成员的专家组对清单的修改稿提出了电子版反馈意见。在后来于弗莱堡(Freiburg)召开的见面会上,由21名专家组成的工作组进一步修订了STRICTA对照检查清单,并计划如何对其进行发布。新的STRICTA对照检查清单作为CONSORT的正式扩展版,包含6项条目及17条二级条目。这些条目为报告针刺治疗的合理性、针刺的细节、治疗方案、其他干预措施、治疗师的背景以及对照或对照干预提供了指南。而且,作为修订工作的一部分,对每一条目作了详尽解释,并针对每一条目给出了报告良好的实例。此外,STRICTA中的"对照"(controlled)一词被替换成了"临床"(clinical),以示STRICTA适用于更广泛的各类临床评价设计,包括非对照结局研究和病例报道。修订的STRICTA对照检查清单有望与CONSORT声明及其非药物治疗扩展版一起共同提高针刺临床试验的报告质量。
文摘In this review,we discussed the findings and concepts underlying the potential role of Helicobacter pylori(H.pylori) infections in the initiation,development or persistence of atherosclerosis and coronary heart disease(CHD).This Gram-negative bacterium was described by Marshall and Warren in 1984.The majority of infected subjects carries and transmits H.pylori with no symptoms; however,in some individuals these bacteria may cause peptic ulcers,and even gastric cancers.The widespread prevalence of H.pylori infections and the fact that frequently they remain asymptomatic may suggest that,similarly to intestinal microflora,H.pylori may deliver antigens that stimulate not only local,but also systemic inflammatory response.Recently,possible association between H.pylori infection and extragastric disorders has been suggested.Knowledge on the etiology of atherosclerosis together with current findings in the area of H.pylori infections constitute the background for the newly proposed hypothesis that those two processes may be related.Many research studies confirm the indirect association between the prevalence of H.pylori and the occurrence of CHD.According to majority of findings the involvement of H.pylori in this process is based on the chronic inflammation which might facilitate the CHDrelated pathologies.It needs to be elucidated,if the infection initiates or just accelerates the formation of atheromatous plaque.
文摘Conventional ultrasound(US)is the recommended imaging method for lymph node(LN)diseases with the advantages of high resolution,real time evaluation and relative low costs.Current indications of transcutaneous ultrasound and endoscopic ultrasound include the detection and characterization of lymph nodes and the guidance for LN biopsy.Recent advances in US technology,such as contrast enhanced ultrasound(CEUS),contrast enhanced endoscopic ultrasound(CE-EUS),and real time elastography show potential to improve the accuracy of US for the differential diagnosis of benign and malignant lymph nodes.In addition,CEUS and CE-EUS have been also used for the guidance of fine needle aspiration and assessment of treatment response.Complementary to size criteria,CEUS could also be used to evaluate response of tumor angiogenesis to anti-angiogenic therapies.In this paper we review current literature regarding evaluation of lymphadenopathy by new and innovative US techniques.
文摘Despite a decrease in gastric cancer incidence, the development of novel biologic agents and combined therapeutic strategies, the prognosis of gastric cancer remains poor. Recently, the introduction of modern immunotherapy, especially using immune checkpoint inhibitors, led to an improved prognosis in many cancers. The use of immunotherapy was also associated with manageable adverse event profiles and promising results in the treatment of patients with gastric cancer, especially in heavily pretreated patients. These data have led to an accelerated approval of some checkpoint inhibitors in this setting. Understanding the complex relationship between the host immune microenvironment and tumor and the immune escape phenomenon leading to cancer occurrence and progression will subsequently lead to the identification of prognostic immune markers. Furthermore, this understanding will result in the discovery of both new mechanisms for blocking tumor immunosuppressive signals and pathways to stimulate the local immune response by targeting and modulating different subsets of immune cells. Due to the molecular heterogeneity of gastric cancers associated with differentclinico-biologic parameters, immune markers expression and prognosis, novel immunotherapy algorithms should be personalized and addressed to selected subsets of gastric tumors, which have been proven to elicit the best clinical responses. Future perspectives in the treatment of gastric cancer include tailored dual immunotherapies or a combination of immunotherapy with other targeted agents with synergistic antitumor effects.
文摘AIM: To analyze contrast-enhanced ultrasound(CEUS) features of histologically proven hepatic epithelioid hemangioendothelioma(HEHE) in comparison to other multilocular benign focal liver lesions(FLL).METHODS: Twenty-five patients with histologically proven HEHE and 45 patients with histologically proven multilocular benign FLL were retrospectively reviewed. Four radiologists assessed the CEUS enhancement pattern in consensus.RESULTS: HEHE manifested as a single(n = 3) or multinodular(n = 22) FLL. On CEUS, HEHE showed rim-like(18/25, 72%) or heterogeneous hyperenhancement(7/25, 28%) in the arterial phase and hypoenhancement(25/25, 100%) in the portal venous and late phases(PVLP), a sign of malignancy. Eighteen patients showed central unenhanced areas(18/25, 72%); in seven patients(7/25, 28%), more lesions were detected in the PVLP. In contrast, all patients with hemangioma and focal nodular hyperplasia showed hyperenhancement as the most distinctive feature(P < 0.01).CONCLUSION: CEUS allows for characterization of unequivocal FLL. By analyzing the hypoenhancement in the PVLP, CEUS can determine the malignant nature of HEHE.
文摘此麻醉安全国际标准由世界麻醉医师学会联盟(World Federation of Societies of Anaesthesiologists,WFSA)和世界卫生组织(World Health Organization,WHO)联合制订。WFSA是由150个国家的麻醉医师组成的非营利组织。本文所推荐的标准已获得WHO和WFSA成员支持,此标准适用于世界各地的麻醉工作者,旨在为麻醉工作者、专业组织、医院、机构管理者和政府提供指导和帮助,以维持和提高麻醉安全和质量。此标准涵盖专业内容、设施设备、用药及静脉输液、监测和麻醉实施等方面。高度推荐标准与强制标准作用等同,包括(但不仅限于):训练有素的、警惕的麻醉工作者持续在场,通过临床观察及脉搏血氧饱和度持续监测组织氧合及灌注;间断监测血压;通过听诊和二氧化碳检测确认气管内插管(如果有)的正确位置;应用WHO手术安全核查单;麻醉结束时完善交接系统。此国际标准仅为最低标准,而我们的目标是以所能达到的最高标准来实施麻醉,所以实际标准最好超过本文所介绍的标准。
文摘Acute epididymitis represents a common medical condition in the urological outpatient clinic. Mostly, epididymitis is caused by bacterial ascent through the urogenital tract, with pathogens originating either from sexually transmitted diseases or urinary tract infections. Although conservative antimicrobial therapy is possible in the majority of patients and is usually sufficient to eradicate the pathogen, studies have shown persistent oligozoospermia and azoospermia in up to 40% of these patients. Animal models of epididymitis are created to delineate the underlying reasons for this observation and the additional impairment of sperm function that is often associated with the disease. Accumulated data provide evidence of a differential expression of immune cells, immunoregulatory genes and pathogen-sensing molecules along the length of the epididymal duct. The evidence suggests that a tolerogenic environment exists in the caput epididymidis, but that inflammatory responses are most intense toward the cauda epididymidis. This is consistent with the need to provide protection for the neo-antigens of spermatozoa emerging from the testis, without compromising the ability to respond to ascending infections. However, severe inflammatory responses, particularly in the cauda, may lead to collateral damage to the structure and function of the epididymis. Convergence of the clinical observations with appropriate animal studies should lead to better understanding of the immunological environment throughout the epididymis, the parameters underlying susceptibility to epididymitis, and to therapeutic approaches that can mitigate epididymal damage and subsequent fertility problems.
基金Supported by Research Grant from the British Medical Research Council, Pfizer Global Research (Sandwich, UK) and the United Kingdom Department of Health Research and Development Fund. SM is funded by a clinical and research fellowship from the Société des Radiologistes de l’Hpital St-Franois d’Assise, Québec, Canada
文摘Ultrasound (US) is often the first imaging modality employed in patients with suspected focal liver lesions. The role of US in the characterisation of focal liver lesions has been transformed with the introduction of specific contrast media and the development of specialized imaging techniques. Ultrasound now can fully characterise the enhancement pattern of hepatic lesions, similar to that achieved with contrast enhanced multiphasic computed tomography (CT) and magnetic resonance imaging (MRI). US contrast agents are safe, well-tolerated and have very few contraindications. Furthermore, real-time evaluation of the vascularity of focal liver lesions has become possible with the use of the newer microbubble contrast agents. This article reviews the enhancement pattern of the most frequent liver lesions seen, using the second generation US contrast media. The common pitfalls for each type of lesion are discussed. The recent developments in US contrast media and specific imaging techniques have been a major advance and this technique, in view of the intrinsic advantages of US, will undoubtedly gain popularity in the years to come.
基金support of the Chinese Academy of Sciences through the Strategic Priority Research Program of the Chinese Academy of Sciences (Grant No. XDA15020100)support by ASI, under the dedicated eXTP agreements and agreement ASI-INAF (Grant No. 2017-14-H.O.)+3 种基金by INAF and INFN under project REDSOXsupport from the Deutsche Zentrum für Luft- und Raumfahrt, the German Aerospce Center (DLR)support of Science Centre (Grant No. 2013/10/M/ST9/00729)support from MINECO (Grant No. ESP2017-82674-R) and FEDER funds
文摘In this paper we present the enhanced X-ray Timing and Polarimetry mission—eXTP. eXTP is a space science mission designed to study fundamental physics under extreme conditions of density, gravity and magnetism. The mission aims at determining the equation of state of matter at supra-nuclear density, measuring effects of QED, and understanding the dynamics of matter in strong-field gravity. In addition to investigating fundamental physics, eXTP will be a very powerful observatory for astrophysics that will provide observations of unprecedented quality on a variety of galactic and extragalactic objects. In particular, its wide field monitoring capabilities will be highly instrumental to detect the electro-magnetic counterparts of gravitational wave sources.The paper provides a detailed description of:(1) the technological and technical aspects, and the expected performance of the instruments of the scientific payload;(2) the elements and functions of the mission, from the spacecraft to the ground segment.
文摘Gallstones represent the most frequent aetiology of acute pancreatitis in many statistics all over the world, estimated between 40%-60%. Accurate diagnosis of acute biliary pancreatitis(ABP) is of outmost importance because clearance of lithiasis [gallbladder and common bile duct(CBD)] rules out recurrences. Confirmation of biliary lithiasis is done by imaging. The sensitivity of the ultrasonography(US) in the detection of gallstones is over 95% in uncomplicated cases, but in ABP, sensitivity for gallstone detection is lower, being less than 80% due to the ileus and bowel distension. Sensitivity of transabdominal ultrasonography(TUS) for choledocolithiasis varies between 50%-80%, but the specificity is high, reaching 95%. Diameter of the bile duct may be orientative for diagnosis. Endoscopic ultrasonography(EUS) seems to be a more effectivetool to diagnose ABP rather than endoscopic retrograde cholangiopancreatography(ERCP),which should be performed only for therapeutic purposes.As the sensitivity and specificity of computerized tomography are lower as compared to state-of-the-art magnetic resonance cholangiopancreatography(MRCP)or EUS,especially for small stones and small diameter of CBD,the later techniques are nowadays preferred for the evaluation of ABP patients.ERCP has the highest accuracy for the diagnosis of choledocholithiasis and is used as a reference standard in many studies,especially after sphincterotomy and balloon extraction of CBD stones.Laparoscopic ultrasonography is a useful tool for the intraoperative diagnosis of choledocholithiasis.Routine exploration of the CBD in cases of patients scheduled for cholecystectomy after an attack of ABP was not proven useful.A significant rate of the so-called idiopathic pancreatitis is actually caused by microlithiasis and/or biliary sludge.In conclusion,the general algorithm for CBD stone detection starts with anamnesis,serum biochemistry and then TUS,followed by EUS or MRCP.In the end,bile duct microscopic analysis may be performed by bile harvested during
